One of the most depressing aspects of public debate in Britain today is its lack of proportion. The sacked minister Peter Mandelson is compared to Dreyfus by his friend Robert Harris (from which we must deduce that Mr Harris, a competent thriller-writer, thinks he is Zola and that Mr Mandelson's supposed "holiday" is actually exile to Devil's Island). A football manager who makes silly remarks about reincarnation is hounded out of his job. The discovery of dead bodies being temporarily stored in a chapel at a hospital in Bedford becomes a national scandal. Now, Professor Dick van Velzen, who collected 6,900 organs and body parts from dead children while in charge of pathology at Alder Hey Hospital in Liverpool, is denounced by Alan Milburn, the Health Secretary, as "gruesome" and "grotesque" and portrayed by the tabloid newspapers as a betrayer of innocents, a monster, a butcher, a Frankenstein.
Professor van Velzen acted foolishly, insensitively, and possibly criminally. The inquiry into Alder Hey found that he stole medical records, fabricated autopsy reports and lied to parents and hospital managers. Many of the organs he collected were never used for research, which Professor van Velzen managed incompetently. But Alder Hey has saved some 1,600 children as the result of new techniques. The picture is of a brash, disorganised man who was not on top of his job and his paperwork, rather than of the Dr Mengele figure portrayed in the press. On a scale of matters that should outrage us, the affair would seem to rank below, say, the patients who are kept waiting for 25 hours on hospital trolleys or the hundreds of children killed on the roads each year. But the press and politicians evoke deep human taboos. The mutilation of bodies in war is regarded with particular horror because it betrays extreme hatred of the enemy; judicial drawing and quartering symbolised the special loathing of treason; a prominent sculptor who used body parts for an exhibition a couple of years ago caused a great outcry. Bodies, we think, should be left in peace.
This is not how doctors see it, particularly if they are involved in research or pathology. To them, bodily organs are the tools of the trade; it is no use expecting them to be as fastidious about such things as the rest of us are. Unless they can remove and dissect organs, doctors can often give no verdict on the cause of death, much less work on new ways of delaying or preventing it. Given the unpredictability of scientific needs, doctors tend to regard hearts and livers and bits of tissue rather as the rest of us regard rubber bands and bits of string: store them away somewhere, even if you don't have any use for them just now, because you never know when they'll come in handy. Who, for example, could have predicted the need for brain tissue from dead people to cast light on the human form of BSE? Medicine, to use Mr Milburn's word, is gruesome; hospital doctors deal with terminally ill patients and dead bodies several times a day. They need a certain insensitivity to stay sane.
Yet the public is no longer inclined to make such allowances; we expect doctors to share our pain as well as cure us; we don't accept the special claims of a professional culture. The decline of deference towards highly educated expertise, indeed, is one of the most important cultural changes of the past 20 years. People now expect as much control over the doctors and teachers who serve them as they expect over a decorator. They will no longer entrust their fate to doctors in a package deal; they will merely give "informed consent", to use the phrase that has emerged from Alder Hey, to specific procedures. But they also expect, more than ever, the professional miracles. They want doctors to continue conquering disease. When their relatives die, they want to know the cause. If their child needs a kidney, they don't want to wait nine months. It is hard to see that these demands can be satisfied if we become too fussed about what happens to bodies after death.
In the wake of Alder Hey, the cry goes up, as always, for more controls, codes of practice and standardised forms. As always, new Labour is happy to oblige. That is the abiding weakness of our public life: as each successive "scandal", in the NHS and elsewhere, arouses the furious demand that something be done, we put in place yet more regulation until, in the end, the entire public sector strangles itself in paperwork. One day, a politician may have the courage to stand up and say: "Yes, it's a bad business but, sorry, I can't do anything about it." It won't be Mr Milburn.
Post this article to
Post your comment
Please note: you will need to login or register before you can comment on the website


